Public Health

Question 1

How can most common cancers be prevented

Answer 1

Diet, weight control and exercise

Question 2

Exercise per week and fibre target

Answer 2

150 mins per week, 30g a day

Question 3

Red meat recommendation

Answer 3

< 70g/day, <500g/week

Question 4

Factors affecting food choice

Answer 4

Housing, employment, education, residence area

Question 5

What can cause a dietary change

Answer 5

Right pricing, marketing and availability strategies

Question 6

Recommended diet for Coeliac disease

Answer 6

Gluten free

Question 7

What can healthcare professionals do to encourage healthier eating habits

Answer 7

Brief intervention, written advice (obesity is risk factor for many disorders, nutrition is important), refer to dietician, guide, reinforce, encourage

Question 8

What is dental caries

Answer 8

Scientific term for tooth decay

Question 9

What index is used to measure dental carries

Answer 9

DMF - Decayed, missing or filled teeth surfaces

Question 10

Measuring DMF, of 32 teeth, a patient has 2 decayed, 4 missing and 6 filled

Answer 10

D = 2, M = 4 and F = 6
DMF = 2+4+6 = 12

Question 11

What factor is involved in unequal distribution of dental caries

Answer 11

Socia-economic status

Question 12

What are periodontal disease

Answer 12

Infections affecting the structures around the teeth. Its earliest stage is gingivitis, infection affecting gums

Question 13

What can periodontal disease lead to

Answer 13

Atherosclerosis, stroke, MI, adverse pregnancy, diabetes, respiratory infections, obesity

Question 14

Treatment for periodontal disease

Answer 14

Oral hygiene, stop smoking, scaling and root planning, surgery, long term maintenance, extraction

Question 15

Example of dental public health intervention

Answer 15

Childsmile - National programme to improve oral health of children and reduce inequalities both in dental health and access to dental services

Question 16

Risk factors for oesophageal cancer

Answer 16

Body fat, alcoholic drinks

Question 17

Risk factors for stomach cancer

Answer 17

Body fat, alcoholic drinks, foods preserved by salting, processed meat (non-cardia)

Question 18

Colon cancer risk factors

Answer 18

Processed meat, alcoholic drinks, body fat, height

Question 19

Decreased risk for colon cancer

Answer 19

Exercise, wholegrains, dairy and calcium supplments (probable)

Question 20

Recommended physical activity per week

Answer 20

150 mins/week or 75 mins of vigorous activity + strength training 2/week

Question 21

Fibre intake recommended

Answer 21

30g/day

Question 22

Upper alcohol limit recommended

Answer 22

Not more than 14 units a week, should be spread over 3 days or more

Question 23

Alcohol and pregnant women

Answer 23

Alcohol should be avoided by pregnant women

Question 24

Acute effects of alcohol consumption

Answer 24

Impairs CNS - Accidents and violence
GI - Oesophagitis, gastritis, ulceration, acute pancreatitis
Respiratory - Overdose, aspiration

Question 25

Chronic disease of CNS in alcoholics

Answer 25

Wernicke-Korsakoff's syndrome - Results from severe acute deficiency of B1 (thiamine). Patient develops Wernicke's encephalopathy leading to Korsakoff'spsychosis.

Question 26

Drinking and the youth

Answer 26

Youths with alcohol-use disorder have smaller hippocampal memory than non-drinkers

Question 27

What can drinking during pregnancy cause

Answer 27

Foetal alcohol syndrome - | 7-14 units/week particularly >= 5 / occasion can cause moderate damage.

Question 28

Signs in foetal alcohol syndrome

Answer 28

Growth deficiency, mental retardation, intellectual impairment, attentional learning disability, behavioural problems

Question 29

Physical features of foetal alcohol syndrome

Answer 29

Microcephaly, low set ears, flat midface, small chin, thin upper lip

Question 30

Alcohol related liver disease

Answer 30

Cirrhosis and alcoholic hepatitis

Question 31

Spectrum of alcohol liver disease

Answer 31

Normal liver - Steatosis (Fatty liver) - Alcoholic hepatitis - Cirrhosis - Cancer (Hepatocellular cancer)

Question 32

Clinical spectrum of actue liver disease

Answer 32

Malaise, nausea, fever Jaundice, hepatomegaly, sepsis Encephalopathy, ascites, renal failure, death

Question 33

Signs of chronic liver disease

Answer 33

Spider angioma, fetors (foul smell), encephalopathy | Prolonged prothrombin time, hypoalbuminaemia

Question 34

Signs of portal hypertension

Answer 34

Caput medusa, hypersplenism, thrombocytopenia or pancytopenia

Question 35

How can cirrhosis be assessed/graded

Answer 35

Childs-Turcotte-Pugh; Originally used to predict mortality during surgery, now to determine prognosis Model for End-Stage Liver Disease (MELD); Initially to predict mortality within three months of surgery in patients who had undergone TIPS but now used to determine prognosis and prioritizing recipients for liver transplant

Question 36

Features of alcoholic hepatitis

Answer 36

Hepatomegaly +- Fever +- Leucocytosis +- hepatic bruit with appropriate clinical history

Question 37

How can alcoholic hepatitis be scored

Answer 37

Glasgow alcoholic hepatitis score - Predicts mortality in patients by lab results and age. Helps determine which patients may require more intensive management based on estimated mortality

Question 38

Treatment for alcohol-related cirrhosis

Answer 38

Abstinence

Question 39

Prognosis for end stage liver disease vs alcoholic hepatitis

Answer 39

Short term - ESLD > ALD | Long term - ALD > ESLD